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Dental Providers Dentist

Provider NPI: 1932234242

Organization Information:
Authorized Official:  CAROLINE J KONTOR  OFFICE ADMINISTRATOR  269-979-9248

Practice Location:
Tel: 269-979-9248  Fax: 269-979-9798

Business Mailing Address:
Tel: 269-979-9248  Fax: 269-979-9798

NPI Information:
NPI: 1932234242
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 122300000X





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